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General NPI Number Information
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NPI Number | 1083813877
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Entity Type | Organization
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Legal Business Name | LARRY E HARRIS OD
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 403 NW LYMAN RD
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City | TOPEKA
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State | KS
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Zip | 66608-1969
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Country | US
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Telephone | 785-235-6550
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Fax |
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Provider Business Mailing Address
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Address Line | 403 NW LYMAN RD PO BOX 8659
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City | TOPEKA
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State | KS
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Zip | 66608-1969
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Country | US
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Telephone | 785-235-6550
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Fax |
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Authorized Official
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Title or Position | OWNER-OPTOMETRIST
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Name | LARRY EUGENE HARRIS
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Credential | O.D.
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Telephone | 785-235-6550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 937-3
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License Number State | KS
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